Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 17th Nurse Practitioners & Critical Care Nursing Conference Dubai, UAE.

Day 1 :

  • Intensive & Critical Care Nursing

Session Introduction

Rafaelly Stavale

Universidade de São Paulo, Brazil

Title: Nursing practices for oral care at ICU
Speaker
Biography:

Rafaelly Stavale is a current student of Nursing at Universidade de Brasília – UnB. She has recently completed the Principles and Practices of Clinical Research (PPCR) course, offered by Harvard Medical School to qualify health care professionals for clinical research. She already presented scientific panels at the XII Reunión de la Academia Iberoamericana de Patología y Medicina Bucal and at the Brazilian Societ of Stomatology and Patology Congress ( SOBEP).

Abstract:

Introduction: Oral care is an elementary nursing intervention for prevention of infections, for instance, Ventilator Asssociated Pneumonia. Despite of it relevance, cronic patients often have their oral condition neglected by health care profissionals.

Aim: To evaluate the aplicability of Nursing Interventions Classification (NIC) for oral health maintenance, promotion and restoration at an Intesive Care Unit (ICU) for patients not under oral diet at a private hospital of Brasília.

Methods: An observational study was conducted from March 18th till April 1st, 2014. Eligibility criteria consited of patients at the ICU service under enteral diet with sepsis. Participants information regarding ICU arrival date, vital signs, undertaken medication, age, disease history were colected. Examination of external and internal oral features were performed in order to monitor patients mouth condition and to identify abnormalities.Clinical examination of oral cavity followed MOUTH acronym order  (Mucous membranes, Oral hygiene, Ulcerations, Type of ventilation, Humidity).

Results: Of eighteen participants screened, five were eligible.Clinical examination of external oral region acknoledged lip epithelial peeling (1/5);tongue adhered to inferior lip due to dryness (2/5). Oral cavity evaluation identified organic deposit on the tongue (4/5),dehydration (3/5),tongue lesion due to trauma with eschar (1/5). Type of ventilation consisted of nasal prongs (2/5),tracheostomy (1/5),endotracheal tube (2/5).

Conclusion: Our results showed neglected care to oral hygiene, moisten lips and oral mucosa against recommendatons of NIC.We highlight the need of nursing capacitation regarding oral care at ICU. More studies should be conducted to evaluate it.

Speaker
Biography:

Gamze SARIKOC has completed his PhD at the age of 29 years from Gulhane Military Medical Academy.  She has postdoctoral studies from Gulhane Military Medical Academy. She is interested in nursing education and simulation. She works on standardized patient methodology.

Abstract:

Aim: Nursing Student Self Efficacy Scale (NSSES) is a short and useful measure that could be used as an objective assessment to ICU patient, of the level of self-efficacy for nursing students. There is no measurement tool to evaluate the skills of nursing students in Turkey. Therefore, NSSES is made of Turkish validity and reliability of the scale in this study.

Method: The sample of the study is to create 284 nursing students. The students were asked to evaluate themselves by applying NSSES two weeks apart.

Results: First, NSSES was translated by the nursing professionals who know Turkish and English and two translation specialist. Then that language equivalency was evaluated by 8 people working as a faculty member in nursing. The original form of two-factor scale, which in our study was found to be the factor of 5. These factors are “Ventilation Intervations Qualifications”, “Basic Skills Competency”, “Intravenous Intervations Qualifications”, “Other Skills Competency” ve “Emergency Cardiac Interventions Qualifications”.  Cronbach’s alpha for the NSSES was .91. The computed test-retest reliability coefficient was .66 (p≤0.05).

Conclusion: Results of this study showed that NSSES had a satisfactory level of reliability and validity in nursing students in Turkey.

Biography:

Abstract:

Developmental Supportive Care (DSC)  is a professional practice, education and research opportunity that nurses need to assess, evaluate and develop continuously within the advance changes in technological environment of the NICU to promote the health status for preterm neonates. The purposes of the study were to examine the effect of cover incubator and voice of mother on the physiological and behavioral health status of preterm neonates and explore the impact of DSC environment on preterm maternal stress level related to alterations in their maternal role, the appearance and behavior of their neonate, and sights and sounds of the unit.

This study used a repeated measure design. Convenience sampling was used to recruit 30 low risk preterm neonates  who admitted to NICU in three private hospitals in Jordan. Data were collected through observation sheet of physiological and behavioral responses  and self administered questionnaire for maternal stress. The instruments used were physiological and behavioral observational sheet (PBOS) and Parental Stress Scale .PSS NICU.

The results of this study showed that that there was significant effect of interventions on Respiratory Rate (RR) (p =0.001) , Quiet sleep (P=0.001) , Tremor (0.002) and Rapid Eye Movement (REM) (P= 0.001)  , on other hand there was no significant impact on O2 saturation (P= 0.7) , HR (P= 0.13 and Motor activity( P=0.12)  with two exceptions for low base line HR   and first response of movement had significant changes after implementing the intervention. Maternal  stress level (PSS.NICU)  assessed before and after implementing DSC ,the  intervention have significant impact on decrease general stress level(P=0.003) , but for subscales there were only significant impact for parental role (P=0.02)   and appearance and behavior(P=0.002)   while there was no significant impact on sights and sounds (P=0.1)

The findings of this study revealed that preterm neonates exhibited significant short term orienting benefit from DSC in relation to some physiological and behavioral variables due to immaturity of preterm systems responses and their maternal short term stress improved after implementing DSC.

Key Words, preterm neonate, developmental supportive care, physiological, behavioral, maternal stress.

Speaker
Biography:

Fateme Hadadain has completed her Ms at the age of 26 years from Ahvaz jounishapoor University of Medical sciencse . She is the faculty member of Deparment of Medical Surgical Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.other authors: Fereshte Jalalvandi: Department of operation room, School of Paramedicine, Kermanshah University of Medical Sciences, Kermanshah, Iran and  Akram Ghobadi Deparment of Medical Surgical Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Abstract:

One of the basic physiological needs of human sleep .While this is a common sleep disorder symptoms in patients with end stage kidney disease. The aim of this study was to determine the effect of progressive muscle relaxation technique on quality of sleep in hemodialysis patients was conducted. In this randomized clinical trial of the effect of progressive muscle relaxation technique on quality of sleep in hemodialysis 100 patients, of Kermanshah Imam Reza Hospital with using Pittsburgh Sleep Quality Epours rs in 2011  was done. The analysis was performed using software Spss 16. In this study, the mean change in sleep quality before and after relaxation In the control group, no significant differences were observed)P=0.15(.Although sleep quality scores before and after intervention, no significant differences were observed in the case group )P=0.005).  Although relaxation, improves sleep quality and sleep quality in patients but failed to reach out to the full extent. And approved by the disrupted sleep quality in patients with severe and uncontrolled factors is influenced.

Keyword: Sleep, muscle relaxation techniques, hemodialysis patients

Speaker
Biography:

Dr.Larissa Martha was a student of Manipal university and Fr.Mullers and has completed her PhD from Vinayaka University. She is the principal and professor in Laxmi Memorial College of Nursing(A.J.Group of Institutions), a premier college of nursing. She has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute state health journal and others. She also presented papers and given lectures in several national and international conferences. 

Abstract:

Critical care nurses are responsible for administering  drugs that affects  patients bodily functions. Lack of adeqquate planning on part of nusers can have harmful consequences like medication errors and can affect patients’ safety. Hence this project was undertaken to assess effectiveness of the structured module on selected drugs used in critical care drugs for staff nurses working in these units. Among the 32 commonly used drugs,  assessment of learning needs of nurses showed that 22 critical care drugs were listed as necessary to be learnt by them. Of the 22 drugs on priority basis 15 drugs were selected to be included in the study. A structured knowledge questionnaire with 50 MCQ was developed in terms of indications, action, dosage, and side effects, precautions and nurses responsibility. A self instructional module (SIM) was developed  and was validated by subject experts. The questionnaire was administered to 30 nurses on day 1( pre-test-24.4) and on the same day SIM was given. After a gap of 10 days on day 11, post test(30.8) showed sigmificant improvement in the knowledge of nurses,  ‘t’(29)=9.227,p<0.01. opinionnaire showed that majority of  subjects’ acceptability to SIM. Post intervention observations showed a better comprehensiveness of nurses in managing critically ill patients as they were better equipped with knowledge on comprehending drugs’ dose, and anticipating the outcomes. They were also directed to keep themselves updated on critical care aspects. All the health team members need to be motivated for updating themselves for maintaining high level of professional accountability in patient safety.    

  • Intensive Cardiac Nursing
Biography:

Helene Ancher Knudsen and Anja Stahl has been working for more than 10 years as Registred Intensive Care Nurses, and are specialized in Cardiothoracic Intensive Care, at OUH, Denmark. Helle Marie Mogensen is nurse in charge at the ICU and Manager on this project. This project has been presented at nurses´conferences both local at OUH and national in Denmark.

Abstract:

Background: A small interview study among elective cardiac surgery patients showed that patients had difficulty remembering pre- information about surgery and ICU stay given orally by ICU nurses (Knudsen, 2013)
Pre-information has a positive effect on patients´ well-being post-operatively (Guldbrandsen, 2010) Videofilm (DVF) based information has shown positive effect on surgical patients´experiences.They felt more confident and prepared for the operation and the post-operative time (Ong et al, 2009 ). No study has included cardiac surgery patients.
Purpose: To explore if oral information in combination with digital video film (DVF) optimizes the effect of pre-information for elective cardiac surgery patients compared to oral information only.
 
Methods: A 10 minutes DVF illustrating the journey from operation to ICU and return to the ward was shown to patients by an ICU nurse in addition to oral information. Patients´ experience was evaluated by questionaries. https://www.youtube.com/watch?v=QWo1eQnbMk4
 
Result: DVF combined with oral information gave patients a perception of confidence and well preparedness. The combination of information forms was better than either of the two separately.
 
Conclusion: DVF is a usefull additional tool in pre-information to help patients manage cardiac surgery.

Speaker
Biography:

Ali Ammouri has completed his PhD at the age of 30 years from Kansas University School of Nursing, USA. He is an associate professor at Hashemite University College of Nursing. He has published many papers in reputed journals related to critical care and cardivascular nursing.

Abstract:

Aim: The aim of this study was to explore the symptom management strategies utilized by post CABG patients and its associations with demographic variables.

Background: A clear understanding of the use of symptom management strategies following CABG surgery may help nurses in developing educational program and interventions that help patients and their families during recovery period after discharge.

Design: A cross-sectional, descriptive design was utilized. A convenience sample of 100 Jordanian patients post CABG surgery selected from five hospitals was surveyed between November 2012 and June 2013 using the Cardiac Symptom Survey. Chi Square analyses was used to examine the associations between the symptoms experienced and selected demographic variables.

Results: Frequency of symptom management strategies utilized by post CABG patients revealed that most frequently employed strategies were use of medications (79%), repositioning (54%) and rest (45%). Symptom management strategies utilized for poor appetite, sleeping problem, and fatigue had significant associations with demographic variables.

Conclusion: By providing information on the symptoms expected after surgery and the possible ways to manage them, psychologically strengthens patients that the CABG experience is within the realm of self-management and coping.

Speaker
Biography:

Mostafa shokati Ahmadabad has completed his PhD at the age of 30 years from Shahid Beheshti University of medical sciences and postdoctoral studies from Lulea tekniska University School of Nursing. He is a faculty member of Qazvin university of Medical Sciences, director of critical care nursing department. He has published 5 papers in reputed journals and more than 35 books in nursing issues and has been serving as an reviewer in BMJ and BMC Journals.

Abstract:

Because of the many problems that are associated with pressure sores, preventing them is one of the most important issues in the scientific literatures. One of the measures used in the prevention of such injuries, identify individuals at risk of pressure ulcer, using predictive criteria. In this study, the accuracy of four predictive tools (Braden, Modified Braden, Waterlow and Norton) to determine the incidence of pressure ulcers in patients in heart surgery ICU in Avicenna hospital of Qazvin. Sampling is available and includes all patients from early August to early October this year. After obtaining permission, the researcher went to the intensive care unit and then studied using tools that includes Braden, Norton, Modified Braden and Waterlow, to examine patients. The researcher checked skin of patients after the surgery and on arrival in the cardiac ICU. The patients were assessed until discharge of ward. Among 70 patients, 32 patients (45/7%) developed pressure ulcers that among 29 patients (41/4 percent) grade 1 and (4/3%) had grade 2 wound. Factors such as diabetes, high blood pressure, and fasting time after surgery, time of intubated, duration of surgery, postoperative hemoglobin and ejection fraction were affecting on ulcers. Low levels of pressure ulcer prevalence in intensive care cardiac surgery. Ultimately It seems that the Waterloo tool is more accurate in predicting the incidence of pressure ulcers. It is recommended to identify patients at risk and reduce the incidence of pressure ulcers, this tool should be used.

Speaker
Biography:

Study about effect of music on amount of analgesics medication use is very limited. In present study, we examined effect of listening to preferred music on amount of analgesic and sedative medication use in patients undergoing cardiac surgery. This randomized clinical trial conducted in Shariati hospital in Tehran, Iran. Fifty patients who were under cardiac surgery were randomly assigned to group "A" (control group) or group "B" (intervention group). Patients in group “A” received usual care after surgery. In addition to usual care, patients in group “B” listened their preferred music. Amount of analgesic and sedative medication used by patients recorded in special forms. Our results showed that patients in group “B” had received less dose of analgesic and sedative compared to the patients in group “A”; mean doses of analgesic and sedative were 1.6±0.74 mg in and 1.4±0.86 mg in patient in group “A” before and after intervention respectively. Mean dose of analgesic and sedative in group “B” was 1.4±0.9 mg and 0.5±0.6 mg before and after intervention respectively. With listening to music, patients needs to analgesic and sedative medication decreased. Music should be considered by clinicians as a non pharmacological, non invasive, simple, cheap, safe, and effective method for pain management after CABG surgery.

Abstract:

Mostafa shokati Ahmadabad has completed his PhD at the age of 30 years from Shahid Beheshti University of medical sciences and postdoctoral studies from Lulea tekniska University School of Nursing. He is a faculty member of Qazvin university of Medical Sciences, director of critical care nursing department. He has published 5 papers in reputed journals and more than 35 books in nursing issues and has been serving as an reviewer in BMJ and BMC Journals.             
 

  • Trauma and Critical Care Nursing

Session Introduction

Tarek Hazwani

King Abdullah Specialist Children’s Hospital, KSA

Title: Skin Care in High Frequency Ventilated Patients
Speaker
Biography:

Tarek Hazwani has completed his MD at the age of 23 years from Damascus University and postdoctoral studies: Pediatrics Critical Care Fellowship from King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA. He is Pediatric Intensive Care specialist.

Abstract:

Pressure ulcers are often considered a problem in the adult population; however, studies shows that pressure ulcers do occur in the pediatric population also.
The review of literature suggests the pediatric population is at risk for pressure ulcer development. It reveals limited information on pediatric skin care issues. The prevention of pressure ulcers and maintenance of skin integrity often is not a high priority especially in the critically ill child, especially those supported on mechanical ventilation.
Prevention and management of pressure ulcers is multifaceted. One must understand the underlying physiology, and the factors that put infants and children at risk for developing pressure ulcers.
The purpose of our review was to document the prevalence of pressure ulcers and other types of skin breakdown in our pediatric critical care unit high frequency ventilated patients by applying new skin care strategies.
 
SETTING AND SUBJECTS: Twenty beds, pediatric critical care unit in King Abdulaziz Medical City, Riyadh, KSA.
In March -2014 , we applied new skin care protocol for High frequency patients aiming zero skin ulcers , which was achieved.
A total of 586 admissions between March-2014 , and Feb-2015 , on bed rest in the PICU for at least 24 hrs without preexisting pressure ulcers we have 259 High frequency ventilation days.
Pressure ulcers were staged according to the American National Pressure Ulcer Advisory Panel Consensus Development Conference recommendations.
 
CONCLUSIONS: The prevalence of pressure ulcers was zero in the group reviewed, who the new skin care protocol applied for them.

Speaker
Biography:

Azam Mohammadi-Almouti has completed her MSc at the age of 30 years from Qazvin University of Medical Sciences. She is a clinical nurse of hospital of Qazvin university of Medical Sciences. She has published 2 papers in reputed journals in nursing issues. 

Abstract:

In order to avoid microaspiration and tracheal injury, the target for endotracheal tube cuff pressure is 25 to 30 cm H2O. To assess the effect of changes in body position on cuff pressure in patients; this quasi-experimental study was conducted on 30 patients in Qazvin hospitals. Cuff pressure was measured in six consecutive positions every two hour: immediately before and immediately, 15 minutes, and two hours after change positions. Data were analyzed at a significance level of 0.05. The right and left lateral/head up 30º and 45º positions for 15 minutes and two hours increased the endotracheal cuff pressure to values above the normal range. The changes in cuff pressure were statistically significant in the mentioned positions (P < 0.001). Minding that still minimal changes in patients’ positioning can result in potentially harmful cuff pressures.

 

Keywords: change Body position, endotracheal tube cuff pressure, head trauma, mechanical ventilation.

  • Healthcare & Healthcare Technologies
Biography:

Dr. G.Hussein Rassool, is Head of Department, Faculty of Psychology, Islamic Online University and he is Executive Director & Clinical Consultant, Sakina Counselling Institute. He has over 45 years of experience both in nursing, mental health and addictive behaviour fields with relevant national and international experience as an educational consultant. During his career, Dr. G.Hussein Rassool has a number of honours including being awarded a Florence Nightingale Foundation Scholarship (for research). He was News Editor and editorial member of the Journal of Advanced Nursing and other prestigious international journals. He is an author /editor of nine books and has published many papers and reviews. 

Abstract:

Professionals are often confronted with ethical and legal dilemmas related to various ethical principles. The aim of the paper is to identify the ethical issues related to patient’s safety in clinical practice.  Many dilemmas are by products of advanced medical technologies and therapies developed over the past several decades.   The  issues in clinical practice  that can  be an ethical concern include: When there is conflict of moral values, beliefs, and objectives; conflict of commitments and responsibilities; when there is the concern that our patients’ rights/values are not respected;  when the issue in focus is related to justice in allocating the available resources; and  inability in decision-making. However, according to the Institute of Medicine report, “patient safety is not solely about addressing general systems issues to prevent the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim (such as administering the wrong medication or dosage). It also includes: “avoiding misdiagnosis, preventing patients from exposure unnecessary risks; and ensuring informed consent.” In the ‘just culture’ context of quality and safety in caring and medical interventions, there should be no harm caused to patients’ due to negligence/recklessness, at-risk behaviour and inadvertent action.  Health care professionals have an ethical duty to advocate for their patients, and it is an expected competence to provide effective advocacy.

 

 

Biography:

Bilkis Adeleye completed her Registered Nursing training from the premier School of Nursing in Nigeria, Lagos University Teaching Hospital. She is a Nigerian Nursing and Midwifery Council licensed perioperative nurse with over 6 years of professional working experience. Adeleye combines her clinical role as an operating room nurse at the Alimosho General Hospital, Nigeria with her interest in research. She is an advocate of research as a tool for enhancing patients’ care and improving professional nursing practice. Adeleye is currently a student at the University of Derby, United Kingdom.

Abstract:

Standard precautions are generally adopted to avert and/or reduce the risk of transmission of blood-borne pathogens among patients and healthcare workers. This aim of this study was to evaluate the knowledge of standard precautions among perioperative nurses in two tertiary hospitals in Lagos, Nigeria.

Eighty nurses (91% females, 34% between 31 – 40 years) participated in the study. The nurses were required to complete a 21-item self-administered questionnaire.  Chi-square statistics was used to test the association between participants’ knowledge of standard precautions and their qualifications, and years of professional working experience. Data were analyzed using SPSS.

The participants’ knowledge of standard precautions was above average (55%). Nurses with a bachelor degree (BNSc) in addition to diploma qualifications [Registered Nursing (RN), Registered Midwifery (RM) and Registered Perioperative Nursing (RPON)] have better knowledge of standard precautions (100% vs. 39%, P < 0.001). Although nurses with RN, RM and RPON qualifications only have better knowledge of the frequency of handwashing in an injection procedure (78% vs. 61.9%), this difference was not statistically significant (P < 0.162). No statistically significant difference was observed between participants’ knowledge of standard precautions and their years of professional working experience (P = 0.662). This study suggests that a bachelor degree qualification may provide nurses with additional knowledge and skills required for safe professional practice. Programs to improve knowledge on standard precautions will be beneficial to all perioperative nurses irrespective of their qualification or experience.

Biography:

Abstract:

The administration of safe medication is an integral part of the patient health management system in the hospital setting.  An estimated 90% of inpatients receive intravenous (IV) medication, and most of the medication is delivered through infusion pumps. The risk of medication error can be greater when medication are administered through intermittent and continuous intravenous infusion. The use of smart pumps technology can be effective and helpful in preventing adverse drug events and intravenous medication errors. This technology is also useful in vulnerable clinical areas where patients are getting large amount of continuous infusion.

A state of science was conducted to determine the clinical effectiveness of the smart pump technology in clinical care in preventing medication errors. The search was conducted through CINAHL, MEDLINE, and SCOPUS databases from 2004 through 2014 using key words infusion pump and medication error, smart pump and medication error, smart pump and adverse drug event, smart pump technology, medication administration and smart pump, medication process, continuous quality improvement and smart pump, medication safety and smart pump, and nurse acceptance and smart pump. The literature was searched in English language to analyze the information accurately. Twenty four research article abstract was reviewed and included 10 publication that focused on the benefits of smart pump technology in a clinical setting and the effectiveness of this technology in preventing intravenous medication errors. Review of ten literature evidences suggest that quality evidence is still required to support the use of smart pumps in mitigating the risks associated with IV medication. Review of several publications showed that well-designed research is still lacking with respect to the effectiveness of smart pumps in preventing medication errors. Nevertheless, the findings in the existing research also reveal new directions for clinical practice and future research.